Psychoactive Drugs Flashcards
(143 cards)
1
Q
Which of the following are not characteristics of depressants? A Decrease CNS functions B. Raise processing speed C. Cause dizziness D. Lack of coordination
A
B. Depressants do not generally increase processing speed as they are lower the functions of the brain. Everything else is correct.
2
Q
How are barbiturates and benzodiazepines similar? How are they different?
A
Barbiturates/tranquilizers and benzodiazepines are both depressants that function in suppressing the functions of the central nervous system. Both are prescribed to relax a patient or induce sleep, however, barbiturates are no longer used due to the high addiction potential. Barbiturates can also be used as general anesthesia or be used as an anticonvulsant (prevent or reduce the severity of epileptic fits or other convulsions) Benzos are more commonly prescribed as to treat insomnia, anxiety and seizures
3
Q
Alcohol falls under the psychoactive drug class: depressants. What about alcohol makes it a little odd and doesn’t quite fit the class?
A
Alcohol has the ability to lower inhibitions, therefore allowing indv to commit to actions that would not normally do, therefore more likely to act on impulses and leads to impaired judgement and reduced self-awareness and self control
4
Q
Name all drugs that fall under the class of stimulants.
A
Caffeine - Amphetamines, ex: Adderall Methamphetamines MDMA/ecstasy/mollie Cocaine Nicotine
5
Q
Along with increased CNS functions, what consequences can come out of stimulants?
A
Along with the increased HR And BP, stimulants can increase alertness leading to an energetic feeling. However, it can cause jitteriness and even nervousness.
6
Q
What about nicotine makes it an oddball in the class of stimulants?
A
Nicotine can cause relaxation, but it can also make a person more alert. [sounds contradicting, but no!]
7
Q
After a long night out, you and Juan are sitting at a diner and realize that he has an interview in an hour. Still heavily drunk, he insists on sobering up with coffee. What should you tell him?
A
He should reschedule his interview. Alcohol and coffee does have polar opposite effects, however, they do not cancel one another out as they do not mechanistically function in the same way. Therefore he will simply be a more drunk person.
8
Q
Besides having the ability to create hallucinations, what other properties does hallucinogens also have? Which other class of psychoactive drugs have the additional characteristics?
A
Hallucinogens also have the ability to excite or calm the indv as well mirroring stimulants or depressants respectively
Hallucinogens also create a sense of connectedness and can induce intense mood swings in a person.
9
Q
What is the experience of hallucinogens dependent on?
A
The exact experiences perceived by an indv, maybe different for another indv because a lot of hallucinogens and their effect are based on indv personalities, where they are, and who they are with.
10
Q
Opiates/opioids are known for their pain relief. However, what other characteristics can they have to cause them to be potentially classified as another class?
A
Opiates can depress the CNS as well leading to a decrease in HR and BP. This is why some drugs under this class are in fact classified as depressants instead. HOWEVER!! The mechanism of action is different. Opiates/opioids bind to endorphin receptors while depressants bind to GABA receptors
11
Q
Which of the following drugs are not opiates? A. Codeine B. Oxycodone C. Barbiturates D. Vicodin
A
C. Barbiturates. These drugs are a part of depressants and represent the classic definitions of depressants: depress the CNS by decreasing HR, BP, and RR through binding of GABA receptors. [remember, opiatea/opiods also act like depressants as well]
12
Q
You find a new drug used recreationally among the projects. What properties must this drug contain in order to be classified as an opioid?
A
It has to be synthetically made to be termed opioids [note: opiates are naturally occurring, though there are used interchangeably; Mneumonic: “at” - n”at”ural - opi”at”es] This new drug has to also depress the central nervous system (therefore decrease HR and BP) and also bind endorphin receptors to create an analgesic effect.
13
Q
Though psychoactive drugs can be classified based on many things, what are the most common classifications?
A
There are many drug classifications that can be denoted, therefore not all a single drug can fit nicely into one category as it may share many similar characteristics of different groups. But the most common classifications are:
Legal system
Likelihood of abuse
Biological effect of drugs (classic classification in psych)
14
Q
What psychoactive classifications (biological effect) does marijuana fall under?
A
None of the commonly listed ones as it shares characteristics of different ones. Marijuana can cause hallucinations but also it can decrease central nervous systems to cause relaxation.
15
Q
Alcohol is known to be a disrupter of sleep. Explain why.
A
Alcohol causes disturbances of REM sleep. This in turn can lead to lack of REM sleep overall and play a role in inhibiting you ability to form memories and new synapses
16
Q
What negative consequence does both depressants: barbiturate and alcohol share together?
A
Both can potentially reduce memory, judgement and concentration. Both do have the ability to reduce anxiety (barbiturates induce sleep while alcohol reduces your inhibitions)
17
Q
As you assess a new benzodiazepine on the market, you are attempting to recall the mechanism of benzos in the body. What happens once the drug has bound onto its receptor?
A
Benzo binds to GABA receptors of neurons, leading to activated chloride channels in neurons to open. This leads to more chloride entering the neurons creating a negative membrane. This low membrane potential leads to the neurons resilience in excitation, hence why they are good rxs for sleep or anxiety.
18
Q
What kind of psychoactive drugs are prescribed for insomnia A Stimulants, Oxycodone B. Depressants, Barbiturates C. Depressants, Benzodiazepines D. Depressants, Alcohol
A
C. Depressants, Benzodiazepines - Short and intermediate acting benzos are prescribed for insomnia only. Long acting benzodiazepines are Rx for anxiety as it has a longer effect. Historically, tranquilizers/barbiturates were Rx for all of these disorders, however, this class of drugs had very addictive potential, leading to the discontinue and occasional use of it only now
19
Q
In terms of prescription, what is one diagnosis that both stimulants and depressants can be prescribed to an individual?
A
Anxiety. Molly/Ecstasy and long acting barbiturates can be Rx to an indv to treat their anxiety
20
Q
What are endorphins and what mimics these?
A
Endorphins are the body’s natural pain reducing neurotransmitters. Opiates mimic these neurotransmitters leading to a decreased in perception of pain
21
Q
What about opiates leads to this class of psychoactive drug to have addictive potentials?
A
With high doses of opiates, indv will have a sense of euphoria leading to recreational uses
22
Q
Nicotine and caffeine are both physiologically addictive chemicals. What do they both share in terms of withdrawal symptoms?
A
Without the substances in the body, users can experience irritability, distractibility, and mood changes (depression for caffeine users and anxiety with nicotine users) They do differ in some symptoms such as caffeine users tend to experience headaches which nicotine users tend to experience insomnia.
23
Q
How does the neurochemical mechanism of cocaine differ from amphetamine?
A
Cocaine causes the release of dopamine, serotonin and norepinephrine which amphetamine (and methamphetamine) causes the release of dopamine only. All 3 causes a sense of euphoria
24
Q
What do most recreational stimulants share in common during the crash stages of substance use?
A
Cocaine, methamphetamine, and amphetamine all depletes their respective neurotransmitters. Once the effect wears off, the crash is experience, where emotional disturbances (such as irritability and depression) and convulsions/seizures can be experienced by users
25
How does methamphetamine and amphetamine’s crash signs differ from cocaine?
Though both share many signs of crashing, cocaine’s crash signs include cardiac arrest and respiratory failure while methamphetamine and amphetamine demonstrate insomnia.
26
What are the difficulties about ecstasy that makes it hard to classify this drug?
It has both stimulant and hallucinogenic properties. As a stimulant, it does raise bodily functions, such as heart rate, blood pressure and temperature. It causes serotonin to be flushed out of neurons which can also lead to damages to these types of neurons. MDMA also has hallucinogenic effects causing one to feel socially connected and intimate with others even as there is nothing in reality that points to it.
27
Your patient comes in and reports he has been feeling very depressed. Though not an addict, he does use mdma many times a year when he travels to festivals. What do you fear has happened?
The chronic use of MDMA for a number of years may have damaged his serotonergic neurons leading to little or no serotonin compared to his normal levels. This could explain his permanent depressed mood.
28
What is the relationship of hallucinogens on serotonergic neurons?
Hallucinogens seem to have a pattern of interfering with serotonin transmission. This relationship has an after effect of indv experiencing an artificial sensation not present in the environment.
29
Those most drugs under the class of hallucinogens do cause some form of hallucination/perception of sensations not present in reality, what forms are specific to LSD?
LSD tends to be visual as opposed to auditory hallucinations.
30
The active ingredient, THC, in marijuana creates what kind of effect on the body?
This ingredient heightens sense in sounds, colors, tastes, and smells and therefore has been associated as a mild hallucinogen.
31
What is strange about THC and why its innate properties don’t allow for a cohesive classification?
Even though THC acts as a mild hallucinogen, it also demonstrates very similar roles like a depressant. In this way, it reduces inhibition and relaxes the CNS. This decrease in CNS function ultimately leads to decrease in motor coordination,imparis perpetual skills, and disrupt memory formation (hence why sometimes it can interfer with short term memory recall) These effects are very similar to the effects of alcohol.
32
Upon arriving at the ER, you find yourself with a very disoriented patient. He states that he is very nervous for his job interview coming up as they will be doing a drug test. To calm his nerves, he decided to smoked some weed instead of drink as he always does. After consumption he bumped his head when he missed a step going up the stairs. His vitals are WNL, and his CT shows no signs of abnormality. What can you report to him?
Alcohol and THC does share very similar effects however unlike alcohol which is eliminated from the body in a few hours, THC can stay up to a week with the system. This is why long time users can sometimes take less of the substance and achieve the same high. Because of this, he may fail his exam if it is detected in his body.
33
You are interning your attendee and he prescribes THC for his cancer patient. As a 15 year old, who has had a few relapses, you question whether this is the best choice for a minor. Why may he be prescribing THC on top of her chemo.
Chemotherapy has lots of side effects and nausea is one. THC has the ability to reduce pain and ease nausea and therefore maybe the best alternative to other addictive medication like opioids.
34
Shadowing a psychologist, you both are interviewing a veteran who has suffered from PTSD with repression. He refuses to open up about his experiences as he sees it as far too hurtful for him, however because of court mandation, he is here. What do you suggest as the next form of therapy?
You can suggest hallucination Rx if he is open to the idea and shows no signs of dependency or drug seeking behavior. Hallucinogens seem to allow people to access painful memories of their past, but in a way that is detached from any strong emotional reactions. Therefore you are able to recall a painful memory and come to terms with it in a way that’s not possible under normal circumstances.
35
What is homeostasis?
The brain and body’s attempt to work and maintain body functions at a baseline. This is achieved through maintenance of your temperature, heart beat, metabolism, etc.
36
How is homeostasis disturbed when an individual first consumes mollie
After taking a stimulant, your bodily functions are distorted away from homeostasis. With the substance, you start to experience speeding up the body functions, a sense of energy and changes in mood, such as an increase in self confidence. These changes cause your body and brain to immediately start to counteract these changes to bring your body back to normal levels.
37
Ritualistic behaviors are often performed with a user, such as smoking at the same place or with specific people at certain times. How does these users’ body react to these behaviors?
Your brain has associated these behaviors and external cues with the use of the substance. Rather than regulating your body only when it has substance, your brain tells your body to get a head start and with increased use, the user will need a higher and higher dose to reach the same level of high.
38
As a sponsor, you arrive at the hospital to your sponsee to find that she relapsed and overdosed. Police officers found her in a location where you’ve never heard before and with people you don’t know. The doctors assure you that the dose she took is just 1 g, her normal dosage. What may be the cause of her overdose.
Because your sponsee is in a new location, her body did not receive the signals to lower her baseline because she was not committing any ritualistic behaviors associated with her drug consumption. Due to this, the consumption overwhelmed her normal homeostatic baseline resulting in an overdose.
39
As a sponsor, you arrive at the hospital to your sponsee to find that she relapsed and overdosed. Police officers found her in a location where you’ve never heard before and with people you don’t know. The doctors assure you that the dose she took is just 1 g, her normal dosage. What may be the cause of her overdose.
Because your sponsee is in a new location, her body did not receive the signals to lower her baseline because she was not committing any ritualistic behaviors associated with her drug consumption. Due to this, the consumption overwhelmed her normal homeostatic baseline resulting in an overdose.
40
Your patient is rushed into the ER after they were released from rehab. Her parents are threatening to have her stay in rehab longer because they argue that she has fallen back into her addiction. Upon viewing her charts, you conclude that this hospitalization was in fact, not from overdose or use, but rather from a crash. Explain this medical phenomenon to her parents
A crash occurs, because there is no substance to counteract the lowered body functions (which results from the body responding to ritualistic behaviors). This may result simply from being in the same environment that she is used to consuming substance. Therefore the best scenario is to remove her from her location where she is unconsciously able to associate her drug habits.
41
Contrast the rate of of absorption between oral intake vs IV intake.
IV occurs within seconds while oral takes ~30 minutes +/- few minutes. This increase in absorption is due to the fact that substance has to travel through the GI in order to be absorbed by the bloodstream. It is one of the slowest routes of entry.
42
After a party, you are hanging out with some new friends and they are “shooting”. What potential dangers does this route of intake hold?
Can be very dangerous because it is much more likely to inject bacteria or other harmful toxins besides the drugs. Especially if you are using unsterilized paraphernalia (misc articles, especially the equipment needed for a particular activity)
43
Contrast the rate of absorption between intravenous and inhalation route of administration.
In textbooks, they are one and the same, however IV can occur as fast as 2-3 seconds, which inhalation takes about 10 seconds. Once consumed through inhalation though, the substance can travel straight to the brain
44
Compare and contrast transdermal route of administration and intramuscular route of administration.
Both are involved with delivering substance to the body through the skin. However, in transdermal, the substance is delivered through absorption through the skin such as a nicotine patch. Whereas an intramuscular injection is delivering substance through a needle into the muscles.
45
```
A nicotine patch can deliver nicotine to the body up to
A. 10 seconds
B. A few seconds
C. several hours
D. 30 minutes
```
Several hours. As a transdermal patch, the concentrations can be very high and can it is released into the bloodstream for several hours
46
An intramuscular route of administration’s rate of absorption ….
Depends on the substance. Depending on the chemical properties of the drug, this method can deliver drugs to your system very quickly or very gradually.
47
Halfway through dinner at Ella, a nearby woman starts having an allergic reaction to the shrimp in her sauce. Thinking fast, you rush over to her and find she has an epipen on hand. Where should the injection be delivered? Why?
An epipen is an intramuscular needle, therefore the Needle goes directly into a large muscle like the thigh. Studies have demonstrated that in order to have the most access points to blood vessels, you need to stick the needle into a large muscle
48
True or False: The rate of absorption of chemicals is dependent on the route of entry solely.
False, it is dependent on both routes of administration as well as the drug’s potential to produce dependence.
49
At a crime scene you are discovering a variety of substances throughout the house. These samples are rushed into the lab and you find that these are drugs with high potentials, including, but not limited to her
People are more likely to become dependent on drugs that take effect more quickly.
50
After studying for hours for the MCAT, you reward yourself with a big piece of cake. After one bite you immediately feel lots of gratitude. Where is this sense of accomplishment and reward located within you?
The reward pathway is located in the right side of the brain
51
What is the role of the hippocampus in the reward pathway?
The hippocampus is responsible for forming memories. Receiving DA input from the VTA allows memory creation of what actions/stimuli that led to this feeling so that the indv can remember for future references
52
Once the prefrontal cortex receives dopaminergic inputs, what occurs? Why?
The prefrontal receives dopaminergic inputs from the VTA which allows the indv to focus their attention and plan around the feelings of the reward and the action that allows for the reward to occur. This behavior is able to occur as the VTA -< Prefrontal cortex is a portion of the reward pathway.
53
Where does the VTA send signals to? What is the input for the pathway?
The VTA sends signals to the amygdala, Prefrontal cortex, hippocampus, and the nucleus accumbens. This pathway is first initiated by feelings of pleasure.
54
```
This is released when the brain first experiences pleasure…
A. Norepinephrine
B. Epinephrine
C. Serotonin
D. Dopamine
```
D. Dopamine is primarily released from the ventral tegmental area in the midbrain. NE and EPI are ntsr used to communicate between neurons of different pathways, where NE is produced in the pons. Serotonin stabilizes our mood, feelings of well-being, and happiness is released by the raphe nuclei (nih)
55
When the Ventral Tegmental Area is activated, it sends its signals to many locations. Of the many, contrast the different functions that result when dopamine is sent to the amygdala and the nucleus accumbens.
Both receive Dopamine inputs from the TGA, however differ on emotion process. Amygdala - deals with emotions. Nucleus Accumbens - controls body motor functions. According to sanescohealth, this is the location in which the feelings of pleasure and reward are created.
56
Components of the mesolimbic pathway include …
VTA, NAac, amygdala, and the hippocampus
57
Compare and contrast the mesolimbic pathway and the limbic pathway.
Mesolimbic pathway is the dopaminergic reward pathway everyone refers to when discussing addiction. It involves the ventral tegmental area of the midbrain and its connections to the PFC, NAcc, hippocampus, and amygdala (it probably has connections throughout the brain, but these are most relevant).
The limbic system is the set of structures associated with emotion. It involves the hippocampus, hypothalamus, thalamus, amygdala, PFC and other more obscure areas (fornix, septal nuclei, etc).
There’s a lot of overlap since the mesolimbic system is essentially a subdivison of the larger limbic system, but the goal is to understand the dominant purpose of each pathway (pleasure + reward related behavior or emotion/fear).
Reddit
58
You and your friend are having a debate about the mesolimbic and mesostriatal pathway. When should you use the mesostriatal system?
It is a term sometimes used to identify the midbrain dopamine projections into the striatum and cortex. It has been described as a combination of the mesolimbic and nigrostriatal dopamine projections, and has been described as being partially asymmetric. (wiki)
59
Chelsea, 29 years old, states that she doesn’t have the physical ability to commit to things that have made her happy in the past. She claims she is still has the ability to remember the things that made her happy, and goes to the extent of planning her day around these things, however, she just doesn’t physically commit to them. What seems to be malfunctioning in her reward pathway
The Nucleus Accumbens seem to be dysfunctional. After uptake of DA by the NA, this nuclei should induce the actions that that led the indv to feel the euphoria
60
A chronic gambling addict comes in for rehab and demonstrates he hasn’t been able to feel emotionally happy as of late. What phenomenon is he demonstrating? What does it demonstrate against previous claims about addiction
Continued activation of the reward circuit and therefore increase of dopamine in the brain is seen to pair with a decrease in serotonin in the brain as well. Serotonin, among its many functions in the body, is partially responsible for feelings of satiation. Decreasing this hormone/ntsr is problematic and hence another reason as to why one must consistently commit to substance abuse or addicting habits to feel satiated. This example demonstrates that addiction and the dopaminergic pathway is a very biologically driven process as opposed to the lack of morals (a thought of the past)
61
The rat park experiment conducted in the 70s and 80s puts these animals into scenarios where they were allowed to self administer substance into their bodies. What is the conclusion that we are able to draw today about the normal brain and the addictive brain as demonstrated from this horrible experiment?
Negative consequences DO NOT affect an addicted brain the same way it does in a normal brain. For instance, pairing a drug with a foul food was not considered a bad action that these addictive brains should avoid. Whereas rats of normal working brains would avoid this food the next time around. Therefore addiction takes over the rational mind
62
Wanting to test a theory out, you hand Victor some edibles with a higher THC content than he is used to. You tell him that this gummy is so yummy and that it's simply just a snack you want to share with him. Throughout the day he is his normal self. What phenomenon is he experiencing?
Behavioral tolerance. This tolerance comes in many forms and is a psychological or learned tolerance. He is acting accordingly because he is under the impression that this is simply a gummy. If he was told that this edible has an higher concentration and he exhibited more extraneous behaviors then he would also be experiencing behavioral tolerance as well bradfordhealth.com
63
Waking up on a Saturday morning, Juan sets out to make you a cup of coffee, your usual routine. However, today, you feel as if you are not awake. What is currently happening?
You are experiencing a form of behavioral tolerance in which you don’t feel the “same” because you have associated this ritual with certain times and places. Whereas if you had this same exact cup of coffee at work, you would feel super energized. bradfordhealth.com
64
How is physical tolerance different from behavioral tolerance?
Physical tolerance occurs at the cellular level and behavioral is a physiological or learned tolerance. Both are used to describe addiction and drug use most together.
65
You are studying a rat who was chronically exposed to cocaine before his euthanization. What about his liver contributes to the rat’s visible tolerance to the same dose of meth?
The liver produces enzymes that break down harmful toxins in the body. This rat’s liver should have an increased amount of enzymes that target methamphetamine, which also is a contributor to physical tolerance. Bradfordhealth
66
It’s labor and delivery training and your student is asking how the body counteracts the use of long term drug use. What do you say.
The use of drugs causes a long term activation of neurons to occur. This long term activation would alter the brain chemistry and overall create bad consequences even death of neurons. Therefore neurons have a mechanism to prevent overactivation of the same stimulus - retracting their receptors from the synapse. This is also the reason why a person is unable to feel the same high with the same dose of their substance (this phenomenon contributes to tolerance)
67
Your friend confides in you that she has been a chronic user of antidepressants for a while now and doesn’t feel like her normal self without it. What has occurred in all of this time through this use?
She has become dependent emotionally and perhaps physically (this is where she may experience negative physical symptoms without it).
68
You and Juan decide to grab a drink with Victor’s friends. You all come to find that one of his friends has a very high tolerance to alcohol and he’s going around the table betting everyone about how much substances he can intake. How has his tolerance affected him socially?
His awareness of his tolerance leads him to be overconfident. Too fast consumption or too much, mixed, etc, can lead to overwhelming effects can lead to a unknown situation.
69
Contrast withdrawal symptoms from a crash
Both are used interchangeably, but to be specific, a crash is what your body goes through when it has lowered your homeostatic level in anticipation of introduction of substance. However, without the substance, your body remains low. A withdraw is more extreme with negative symptoms that vary from drug to drug
70
Your sponsee is a chronic user of cocaine and has been clean for 5 years. However, after his parent’s death, he relapsed and has been missing for a few months, until you final get a call from the ER, where he is currently hospitalized. What withdrawal symptoms is he probably experiencing during his extended stay there?
depression, irritability
71
True or False - Because of the great changes drugs can have on the brain, recovering and having a normal homeostatic brain again is difficult and very unsuccessful.
False. The brain is very flexible and therefore just as the brain is able to grow tolerance by decreasing its response to the substance, it can also change back to normal homeostasis after the drugs are absent. This doesn’t mean that the damages done from substance use can repair though.
72
The term intoxication is used loosely by lay people. What is the correct definition of intoxication?
This is the condition that follow the administration of a psychoactive substance that results in the expected effect of the drug such as but not limited to: cognitive and perceptual limitations. This word is not just defined after a person has had too much of a substance (lay person’s def)
73
Withdrawal symptoms are quite unique to the substance. What is dangerous about the withdrawal symptoms of alcohol?
Along with many common Sx seen in many psychoactive drugs such as cold sweat, anxiety, and nausea, seizures can also accompany alcohol withdrawal, marking this a very dangerous time for an alcoholic
74
You meet a woman on the bus who is complaining about her doctors denying her desire for more painkillers. She yells about how she’s experiencing lots of grief, she’s constantly anxious and can barely sleep for a long time now. When you ask her if she’s a drug user, she snaps sharply and denies very aggressively. What are your suspicions?
She may be a drug user even though she is denying it. All of her symptoms (mood disorder, anxiety, and sleep disorder) can be conditions caused by substances. Other disorders that can manifest from drug use are sexual dysfunction and psychosis.The fact that she is demonstrating drug seeking behaviors also points her to substance use disorder.
75
Angelie sharply notes about how the woman dancing in the street is a little “crazy” as you two are driving home. Taking a second glance, you note that she is homeless and lives near the “walmart of heroin”. How can you describe her “crazy” in better terminology? Where is it produced from?
The “crazy” angelie is referring to is psychosis (a loss of contact with reality; paranoia and hallucinations outside of drug use). It can manifest as a result of drug use
76
As a healthcare administrator, you are revising the questionnaire for patients. Under the list of questions about drug use, you can see two questions about usage:
(a) Are you currently using drugs. If so what kind?
(b) Are you increasingly using large amounts?
(c) Are you failing to cut back from usage
What other questions can be listed under here for thorough assessments?
Are you spending an increased amount of time recovering from substance use or trying to get the substance?
Are you experiencing problems related to obligations at work, school, or home
77
After surveying your patient for their drug use, you see they have identified only 2 yeses on: Are you currently using drugs and are you increasingly using larger amounts. Is this enough to make a diagnosis?
Yes, There is no need to answer yes to all questions. As long as the yes is not solely just the first question. The degree of their yeses determine the degree of their substance Use disorder
78
What are some aspects we can use to diagnose someone with substance use disorder?
Look at their use through questionnaire, assess them for presence of withdraw, and identify if they have a tolerance to a substance
79
True or False: All psychoactive drugs have a potential for substance use disorder.
False. Not all psychoactive drugs have a high/any addictive potential. These include Caffeine (a stimulant), ecstasy (stimulant), most Hallucinogens.
80
Does marijuana have a high addictive potential?
According to NIH, the strains in THC today have a higher concentration compared to strains in the 60s. This increase in potency means that is can lead to addiction and in fact only 9% of those using it has become addicted to. There is a corelation with use at a young age, the younger the use, the increase in addiction rates (17% of those who start using as teenagers will become addicted) and daily users have a tendency of 25-50% addiction rate. [note: this is not required for MCAT]
81
Upon arriving to inpatient, your young patient is experiencing lots of Sx. She is a chronic methamphetamine user and was found overdosed in an alley. She was brought in on an involuntary 72 hour hold and you have until then to decide if she should extend her stay. What is she currently experiencing at the moment?
Detoxification and withdrawal. Detoxification is the process in which the substance is “flushing” out of the body, and due to this, the body and brain undergoes withdrawal symptoms as it reacts to the low levels of substance
82
As an individual undergoes detoxification, how can medicine intervene?
Hospitalizations maybe necessary ad medication can be prescribed to either ease the symptoms or given to substitute the drug as a person goes through treatment for their substance use disorder
83
Your neighbor has a chronic opioid use disorder and is recently undergoing treatment. Wanting to be a good neighbor, you decide to bring her a casserole and check up on her. You walk in while she is just about to shoot up. What is your biological response as to why this is not a good idea?
While she is in treatment and taking methadone, shooting up on opiods is not going to create the high and euphoria she is looking for. Methadone is an agonist, therefore mirrors the complex of heroin, and binds to the opiate receptors. While methadone is present, she won’t be able to feel the high of her drug because the methadone blocks binding, and may even overdose.
84
Your new patient is here for a follow up and he confides in you that while he is taking methadone, he feels very lousy. He doesn’t particularly feel happy and wants to stop using. What is your response?
While that may be true, this is the expected effect of the drug. Methadone is an agonist, therefore mirrors the complex of heroin, and binds to the opiate receptors. However, because methadone is a slowly acting drug, the high is not addictive and is dampened even. It is not supposed to allow you to feel the same high as you were on recreational drugs, but it does help you reduce your cravings and ease the withdraw Sx. He should continue to keep taking it along with behavioral therapy as these work best when they are done together.
85
Much like opioid detoxification treatment, nicotine addiction can also go hand in hand with medication as well. What physiological effect does this treatment have?
Rx with low [ ] nicotine are delivered to the body through a patch, lozenge, etc. The nicotine binds to nicotinic receptors in the brains and prevents reuptake of Da (reward circuits). Through this mechanism, it prevents cravings.
86
Compare the treatment for alcohol detoxification with the nicotine detoxification treatment. What is the purpose of this treatment?
The medication given to to patients undergoing alcohol detoxification blocks the receptors involved in reward circuits (much like nicotine detoxification treatment) This reduces the effects of drinking and craving as well as eases with withdrawal Sx: Anxiety, insomnia, and dysphoria (a state of unease or generalized dissatisfaction with life)
87
You’re speaking to Kathleen and she states that one of our patients refuses to do behavioral therapy. Why is treating addiction from the psychological aspect important?
Oftentimes, the start of substance abuse stems from physical symptoms already. Therefore, in taking on the psychological perspective and in minimizing negative psychological Sx, the patient’s outcome in recovery is much higher.
88
What type of care can behavioral treatments take place in?
Inpatient and Outpatient care. Inpatient treatments require residents to stay in a hospital or other facilities while they are receiving treatment. In contrast, Outpatient facilities allow patients to live outside of the facility and only come onto the facility for therapies, treatments, etc.
89
Under the behavioral treatments, contrast cognitive behavioral therapy from motivational interviewing.
Both are methods of behavioral therapies for patients diagnosed with substance use disorder. Motivational Interviewing or Motivational Enhancement Therapy is the focus of one on one/therapist-patient work. This time spent will be involved in working with patients to find intrinsic motivation to change. This form of therapy often times are gated way treatments and allows room for other treatments to be involved. CBT address cognitive and behavioral aspects of addiction by teach recovering addicts life skills to use in tough situations.
90
During your time with Sarah, your recovering addict, she confides she is most afraid hanging out with her friends. Oftentimes at parties, there are always drinks, and she doesn’t feel that she can handle her situation well. What is your next step?
Prescribe her to cognitive behavioral therapy on top of her existing treatment. These sessions will allow her to recognize problematic thought patterns and learn how to develop more positive thought patterns and coping behaviors. These coping behaviors will include learning how to self monitor for craving, so that she can apply her coping strategies early
91
In contrast to medication during detoxification/recovery periods, how does CBT differ from it?
Research demonstrates that skills learned during CBT last long after the therapy has ended. This is important for recovering addicts to return to a sense of normal
92
Group meetings often are associated with programs such as 12 steps for recovering addicts. During the stage of surrender, what is expected of the recovering addict?
They are expected to give their self over to higher power and accept help given by the higher power and through the group (Step 2 of the shorter version)
93
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The first step to the road of recovery is
A Active involvement
B Surrender
C. Honesty
D. Courage
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C. Honesty - This is the acceptance stage in which addicts have to acknowledge that addiction is a chronic and progressive disease. This disease cannot be controlled by the addict themselves
94
In the shortened version as described by KHAN, what is the last category of the 12 step recovery program for addicts?
Active involvement in meeting and activities
95
How can families and friends cope with acknowledging and dealing their loved ones are addicts?
Recovery programs for addicts tend to have parallel family therapy session that help the people in the addicts life understand the problem and help them help their loved ones
96
T/F - On the road to recovery, many people consider the idea of relapse as part of their journey and account for it
This is true! This idea is considered widely in therapy and this is why CBT can become very useful in reshaping a recovering addicts behaviors in situations they can’t control
97
What refers to the fact that after getting used to the effects of a drug, one needs more of a drug to achieve the same high? A Tolerance
B. Withdrawal
C. Intoxication
D. Relapse
A Tolerance
98
The road to recovery for patients diagnosed with PTSD always considers?
That recovery for the patient does not mean that the patient will be completely whole again as if trauma never occurred. Recovery understands that these patients might never be the same again but recovery should allow the indv to live healthy and happy
99
Along with pervasive negative thoughts and intrusive memories/nightmares/flashbacks, what else should you consider in diagnosing your patient with PTSD?
Avoidance of situations associated with the event and excessive physiological arousal. These 4 are the major types of PTSD in the DSM V
100
Mark comes into the office with his girlfriend Twyla. Today they are having a couple’s therapy to overcome and assess Mark’s PTSD. She admits that at night Mark tends to go through bouts of shouting, sweating, and lots of muscle tension when he sleeps. He also refuses to go out to the bar at night with friends. What other questions or topics should you ask in order to better diagnose him?
Because these are symptoms of excessive physiological arousal and avoidance of situations. You should also ask them questions about reliving his trauma and pervasive negative changes in emotion and belief. These are the 4 major clusters in the DSM V of PTSD.
101
Sarah has been in the group for a while however she never talks, and never shows any range in mood. Often she is seen gazing or daydreaming. She first came into group due to her traumatic sexual assault she experienced at a younger age with a serial psychotic. What is exhibiting?
Dissociation - feeling as if situations aren't real or are surreal, feeling like time has slowed down or sped up or even blacking out. These include experiences of numbing or periods of feeling emotionless or emotionally flat
102
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Across many studies women in treatment for substance abuse due to rape or sexual assualt range from
A ¼ - ⅓
B ⅓ - ½
C ½ - ¾
D ¾ - ⅘
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B ⅓ - ½
103
Fear conditioning in PTSD states …
And indv suffering from PTSD Sx is due to trauma inflicted onto the indv in the past. These create unshakable memory of being in mortal danger and learned responses stem from that memory
104
A 39 year old patient comes into the office. Today he confides in you that he’s having an internal turmoil because he relives his time when he was in the bunker. He worked as a drone operator and surveyed a village nearby for a number of years. However, one day, he was ordered to bomb the village. Unable to deny higher authorities, he did so and ever since then, it's eaten him up. What medical phenomenon is he experiencing that has been recently included into the categorization of PTSD
Moral injury - the indv suffering from Sx of PTSD has an internal issue of not reliving events not done onto him, but his actions onto others. These then create intrusive memories, nightmares, depression, anxiety (Sx of PTSD)
105
What neurological phenomenon does PTSD mirror with anxiety disorder.
Anxiety disorders are psychological disorders are both characterized by distressing, persistent anxiety or maladaptive behaviors that reduce anxiety. Brain’s limbic system may flood the body with waves of stress hormones like [Limbic system again includes: Hypothalamus, amygdala, pituitary gland, and hippocampus] cortisol every time images of the traumatic event bubbles up uninvited into consciousness
106
You are assigned to study boys who first joined the military and assess them after they are discharged. Many of your patients are actively suffering from PTSD. Through neuroimaging, what medical phenomenon do you find?
Through neuroimaging, you may find that the hippocampus is quite damaged and even shrunken in size from when they were younger. This occurs when trauma or chemical processes set into motion by trauma (such as increased cortisol from increased stress)
107
With injury to the hippocampus, what can you expect to happen as a result especially for the patients diagnosed with PTSD?
The hippocampus, among many of its roles, play a role in consolidating memory. Damage to this center may explain how memories associated with trauma could fail to be filed away as long term memories and instead remain vivid and fresh flashbacks and nightmares.
108
Watching the inauguration of Biden, you sit silently at Amanda Gorman as she delivers her poem. She bravely touches on her life and urges for the future. As you sit there you, you soak in her touching story and how far she has come and how her plans to become a president one day. Despite all of her struggle, what psychological phenomenon has she demonstrated?
Post-traumatic growth, the positive psychological changes resulting from the struggle with challenging circumstances and life crises
109
After getting gas at the convenience store, you notice a man sitting on the curbside so you buy him a sandwich and get to talking to him. He confides that ever since he was discharged from the military, he hasn’t felt the same and since he’s been back, he started drinking. It got to the point that he has to bunk at his friend’s house now because his wife does want him around anymore. Based on this conversation, what is he suffering from?
He’s suffering from substance use disorder secondary to his underlying PTSD. Oftentimes, addiction is secondary to the real underlying problems that an indv suffers from and substance is simply his self-medicating process (coping method against his trauma)
110
You are sitting with a patient and she cries about how unfair her medical treatment for her substance use disorder is. She claims that she is being discriminated against and forced to never touch a drop of heroin again, yet her roommate can have the leisure of drinking once a week. Assessing both, you come to conclude that they both have similar backgrounds. Why is it possible that two people of the same background, culture, schooling, etc require different treatment plans?
There are many factors that modern medicine can’t tease out. Due to differences in genetics and environmental factors, their treatment plan will be different as your patient needs to say complete sober in order to recover, her roommate has the potential ability to gain control of her substance
111
There is lots of debate as to treatment, causes, effect of addiction and social/underlying problems. What are two facts that are not debatable in the community?
There is no question that people begin to heal and recover (for PTSD and addiction) when resources are available to them AND that to treat addiction, one must treat the underlying issues as well.
112
True or False: To treat the underlying causes of addiction, one must treat their addiction first.
False, there is large debate about this and until then, this can not be proven. As a matter of fact, because these two: underlying trauma and addiction is seen to go hand in hand so often, many modern medicine has turned to the theology of dual diagnosis model of treatment, in which both physical and psychological aspects of the addiction are treated simultaneously
113
Bored of studying, you decide to turn on the TV as you are watching and typing a KHAN academy lecture. Why is this such a bad idea?
Multitasking leads to a divided attention. And as attention is a limited resource, in reality you are only able to concentrate one thing at a time even if you are unaware of it. And because the MCAT is a harder stimuli to capture and understand, you’ll have a much harder time paying attention to this. Therefore, when you commit to this, you potentially may not be absorbing everything you are studying and WILL FAIL the MCAT again
114
Contrast divided attention to selective attention.
Selective attention is concentrating on one stimuli at a time, this occurs by blocking out other stimuli of the environment. Divided attention however is committing to two or more tasks at once (study.com)
115
Why might sustained attention not be enough for you to do well on the MCAT? What must you commit to?
Sustained attention is commonly referred to as someone’s attention span. This takes place when we continually focus on a task at hand for a long period of time without losing focus and having to keep bringing it up. To really succeed in the MCAT, you must commit to executive attention. This is the process of clocking out unimportant features of the stimuli and attending to what really matters. The executive portion is listing and planning your goals, tackling these goals and tracking your progress through the time you commit to this. (study.com) [note: all of this comes with time AND practice]
116
As you are studying for the MCAT, you keep getting distracted by the clinking sound of the lamp’s extension cord hitting against the table legs. Annoyed you refocus, but every time you start to pick up on your studies you hear it again. What causes your attention to switch back and forth?
The exogenous cue (an external stimuli in the environment) of the clinking sound shifts your attention, however, as your opened documents/endogenous cues (cues that signal your internal knowledge/goals/plans etc.) shifts your attention back to your studies
117
During a party, you are talking to Juan, engrossed in your conversation. However, you hear your name across the room and automatically turn your head to find Victor laughing. What kind of stimuli was your name?
This is an example of the cocktail effect (a great example of how selective attention works). Your name is an endogenous cue in which you know and understand the word, which causes you to shift your selective attention from Juan to Victor.
118
At Roots Run Deep during a wine tasting, you and Juan are engrossed by the warm sun and the delicious wine. As you two are staring into the beautiful scenery, Juan states that the golf course is so pretty. Shocked, you turn your head and realize there is a golf course there the whole time. What type of blindness did you just experience.
Inattentional blindness - means that we are not consciously aware of things in our visual field when our attention is directed elsewhere within that field. Therefore the things we are not aware of is lost to us
119
As you and Juan park to see the meteor shower for the night, you are mesmerized by the stunning sky. Engrossed in the scenery, he mentions that the moon has disappeared since you two are parked. What type of blindness did you just experience.
Change blindness - When we fail to notice changes to the environment. This means that you fail to notice a previous state and a current state.
120
Curious to see how well Alex’s selective attention is, you decide to set up an auditory experiment. What design should you mirror yours to?
To the shadowing task, where he puts on headphones and is asked to repeat what he hears only through one ear. This way, you can see how well he ignores incoming stimuli and how well he can stay focused on the other stimuli
121
Broadbent’s Early Selective Theory has reshaped the world of psychology incredibly. Elaborate his theory concisely.
(1) All information are captured and stored at a Sensor Register
(2) Information is immediately forwarded to a selective filter which filters out unimportant and unattended stimuli
(3) The selected filter forwards information into the Perceptual processes where these important and attended stimuli are given meaning
(4) Perceptual processes are forwarded to cognitive processes where it reaches your consciousness and you can respond
122
Which theory of selective attention was overthrown by the cocktail effect party? Why?
Broadbent’s Early theory was overthrown by the cocktail effect results. The experiment demonstrated that even as an indv was not attending to their name, they were still able to capture it, give meaning and reach their consciousness. This idea goes against Broadbent’s because he states your name should have been filtered out and never been given a meaning and never reached your consciousness
123
How did the Deutsch and Deustch’s theory move away from the early selective theory?
These men’s late theory moved the selective filter seen in Broadbent’s early selection theory after the perceptual process. This means that they believe the body processes all sensory information it receives and assigns meaning to it. However, once meaning has been assigned, these information is then forwarded to the selective filter, where the only the important and attended information passes through to consciousness.
124
The late theory of selective attention appeared like a breakthrough to understanding how selective attention functioned. What potential problem do you see in it?
It's an evolutionary, energy disadvantage to give meaning to all sensory information if this information does not reach consciousness. [note: this is the same problem with Treisman’s but not to the same extent as stimuli are weakened]
125
How did Treisman’s theory evolve from Broasbent’s original theory of selective theory just like Deutsch and Deustch?
Treisman’s Attenuation Theory. He states that instead of a filter in Broadbent’s original theory, it is actually an attenuator. Therefore it weakened unattended stimuli but it does not eliminate the stimul completely. After this attenuation, it follows the same process as Broadbent’s theory in which the information is sent to perpetual processing to be given meaning and then sent to consciousness. This means that the weakened information still receives meaning.
126
How is Treisman’s theory different from the previously created theories about selective attention?
He demonstrates how one’s attention can shift. He argues that because the weakened stimuli receive meaning as well. Once it holds meaning, and the meaning of the unattended stimuli is important to you, you will shift your attention and attenuate the previously attended information.
127
Attempting to test the different theories of selective attention out, you conduct a few experiments. You want to see how the different tasks affect selective attention. What is your expected result?
You should expect to see that the difficulty of the task at hand does affect the the filtering process in when the filtering occurs and how long it takes for an indv to filter information [note: because these 3 theories of selective attention is highly debated, conducting experiments to prove one as definite it hard]
128
the spotlight model and the resource model share….
While both are different, they focus on the idea that attention when split does not result in good outcomes. Therefore multitasking is a bad idea.
129
Contrast the Spotlight theory of attention from the Resource theory of attention.
The spotlight theory of attention elaborates even as we are processing all sensory information on an unconscious level, our conscious attention can only take in certain aspects of the sensory info at one. The resource theory states that attention is a limited resource and these resources can easily become overtasked when we try to pay attention to multiple things at once
130
How is memory and attention similar?
Much like attention, memory recall of certain things can become difficult even though you’ve seen it a lot of times. This is beaucase when you don’t pay attention to it, you don’t form any conscious memory about it
131
As Professor Dadel lectures about how to use this new equation, he slowly goes through the process of how to work it out. He continues to commit to this form of teaching for about 4 problems, each one with different values, but all the same. Frustrated by how slow he is, you work ahead and sit there waiting for him to finish the lecture. What allowed you to complete this? How does this phenomenon relate to attention?
Priming - an effect that occurs when you have been exposed to one stimulus. This preexposure influences you to respond to another stimulus. Therefore, you were primed with how to attend to certain portions of the problem to allow you to solve the problem.
132
Thinking about the cocktail party effect. What does your name showcase in this scene?
It demonstrates a strong prime in which we all grow up learning to respond to our name. Therefore our reflexive change in attention when we hear our name is the process of priming that shifts our selective attention
133
The dichotic listening task/shadowing task produced profound results in participants. These results demonstrated
That the average person is able to recall a lot more information on tasks they attend to than to tasks that they were ignoring. This reinforces the implicit idea that multitasking is a very ineffective strategy
134
Lou is driving you and her to the mall for a big sale at Bath and Body Works. As she is driving, she pulls her phone out and starts texting. Concerned, you ask her not to do so, but she assures you she is very good at multitasking. Apply the spotlight and resource theory of attention to this scenario. What is she doing based on the two models?
The two theories state that she is not multitasking, but in fact shifting her attention from one task to another. Therefore as she is texting, her performance at driving will greatly decrease and vice versa
135
Meghan ran late to work and is rushing to do everything before her meeting. As she is sitting at her desk, she starts to rapidly apply her foundation while typing her meeting notes. Concerned, ask if what she’s doing is the best idea, and she states that this is something she has always done. What three factors are important to perform many jobs at once? Why might she be right?
The factors that affect if someone can perform many tasks at once are: (1) if the tasks are similar (2) how difficult one or both of the tasks are (3) if a task has been practiced. Meaghan may potentially be able to do everything because she’s practiced this many times in the past.
136
Desperate to complete your personal statement, you rush to organize all of your paragraphs. However, you’ve ignored it for so long because you find it quite boring, so you decide to turn on some NPR. After 30 minutes, you find that you have written nothing down and have no idea what the podcast is saying. Why are you having such a difficult time completing these jobs?
Both tasks are very similar and require the same portions of your brain to commit to each task (verbal processes and skills) According to attention studies, increased in similar tasks, increases the difficulty of multitasking them simultaneously
137
You are studying for the MCAT and happen to come across Fluids in physics, a topic you deeply hate. Your neighbor decides to turn his music on as well at the same moment. What factor is preventing you from listening to music as you study?
The difficulty of studying is making your multitask much harder. Studies have shown that the harder one or all tasks are, the more difficult it is to perform them successfully at the same time.
138
Ms. Souza is rapidly chatting away with Gill as they pitch softballs to one another. There seems to be an easy between the two things they are doing and in fact have so much fun committing to it. What factor of multitasking is allowing this ease in multitasking?
Practice. Both have practiced perfecting their pitches and can easily talk about other things while they reflexively commit to it.
139
Differentiate automatic processes and controlled processes. What aspect of psychology does these two terminologies fall in?
Automatic processes are well practiced tasks allowing for the task to occur without the need of conscious attention and controlled processes are processes that require conscious effort. The difference between the two are simply the practice involved therefore controlled processes can become automated processes. These two terms are a part of the factor, practice, in affecting multitasking
140
True or false: Studies have shown that high levels of social media use causes poor student grades.
False. While there are studies that demonstrate the correlation, the causation of the two are not quite known yet.
141
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Of the four main classes of drugs, this class is known for causing distorted perception in its users, including drugs like LSD and Psilocybin (in mushrooms)
A) Depressants
(B) Stimulants
(C) Hallucinogens
(D) Opiates
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C Hallucinogens
142
A major problem in recovering from drugs is the tolerance/dependence that the nervous system can develop for outside sources of dopamine and/or serotonin. What happens in the neural synapses to cause this decrease in dopamine/serotonin production?
When the drug is taken initially, the synapses are flooded by excess dopamine/serotonin. With this overstimulation, the brain can lower production of these neurotransmitters and/or the number of channels in the membrane, decreasing sensitivity.
When the drug is taken initially, the synapses are flooded by excess dopamine/serotonin. With this overstimulation, the brain can lower production of these neurotransmitters and/or the number of channels in the membrane, decreasing sensitivity.
143
Dopamine is involved in many neural activities. Match the structure to its activity caused by dopamine:
(1) Amygdala
(2) Prefrontal Cortex
(3) Hippocampus
(A) Memory formation
(B) Emotion
(C) Attention and planning
(1) Amygdala -> (B) Emotion
(2) Prefrontal Cortex -> (C) Attention and planning
(3) Hippocampus -> (A) Memory formation
